Enough is Enough

In October of 2011, Dr. Oz wrote an article for Time Magazine titled “Enough is Enough – while we fight over health care reform, more blameless Americans grow sick and die.” He had recently volunteered at a free clinic and was particularly moved by two patients. His article ends with this: “At what point, I wondered that day and still wonder now, will we finally say enough? The medically underserved are, most commonly, the medically uninsured, and they number in the tens of millions. I don’t underestimate the complexities of implementing a health care reform law that we can all live with…but we’re not perfecting the law; we’re fighting over it. Politicians dither and people die. Lawyers argue the merits of this or that technical point, and more blameless Americans grow sick and slip away. This isn’t just a failure of politics and policy; it’s a failure of basic morality.” http://ideas.time.com/2011/10/31/enough-is-enough/#ixzz2dIuANvKS
It is now almost two years later and our politicians still dither and people are still needlessly dying. Regardless which side of the aisle you sit or how you feel about the Affordable Care Act – it is deplorable that here in America people are dying due to lack of health care. While we continue to argue whether the ACA will save money or bankrupt America, are you aware that more than 23 million people will still lack insurance after the act is fully implemented? In New Jersey, Gov. Chris Christie’s controversial decision to participate in the ACA’s Medicaid expansion extends coverage to 300,000 people – nice sound bite -but unfortunately one million people in New Jersey will still lack coverage.
In Cape May County, one in five lack access to health insurance. Health insurance is a primary factor in whether and when people get necessary medical care and, ultimately, how healthy they are. Those without health insurance are far more likely to postpone or forgo health care.
People without health insurance go to the ER with strokes and heart attacks. They are stabilized and advised to “follow up with their primary care doctor,” only they don’t have one – so a few weeks later they are back in the ER or dead. Diabetics without insurance struggle to pay $100/month for insulin – so they skip a dose or water it down or stop taking it all together. Eventually they wind up in the ER. Much later, after the disease has ravaged their system, they will finally qualify for Medicaid. We know preventative care ultimately saves money so how can this make sense – medical, financial or moral?
While the nation struggles to find a solution to our broken health care system, there is a small group of people making a difference every day. I refer to our free clinics; I speak specifically of Volunteers in Medicine of Cape May County (VIM). Free clinics are a perfect example of what is good about America. They are a grassroots movement of neighbors taking care of neighbors. Free clinics are a different model of health care and healthcare delivery. Free clinics receive no Federal funds; typically operate on a shoestring budget and are dependent on the good graces of their local community for support.
I am proud to serve as Executive Director of VIM, a clinic staffed almost entirely by volunteers – more than 100 of them who log more than 10,000 hours per year. Volunteers like Dr. Ken Cramer who is in active practice at Cape Urgent Care, has a family and personal responsibilities. He is a busy man, as most are, but still he finds time to volunteer at VIM and provide much-needed primary care to people without insurance.
Volunteers like Dr. Steve Kornberg, a cardiologist who called to donate a piece of office equipment but quickly realized we would need his medical skills to truly take advantage of it. Now he and his two daughters volunteer. Volunteers like Wanda Jones who heard me speak at a Sons of Italy meeting and shyly asked “I’m not a nurse or doctor but could you use me somehow?” She now covers our front desk twice a week, warmly greets our patients and keeps our schedule flowing.
It is interesting to note, most patients that go to free clinics (83 percent nationally) come from a working household. A common misperception is “your patients are living on the dole” but that is just not true. Someone in the household is working, they just can’t afford or don’t have access to health insurance. Consider for a moment the types of jobs available in Cape May County, with our service and tourism economy; we don’t have the kinds of jobs that typically offer health insurance.
To be eligible for service at VIM, one must reside in the county, have no access to health insurance and earn no more than 250 percent of the Federal Poverty Guidelines (approx. $38,000 for a couple.) The vast majority of VIM patients survive on far less. Almost all work but mainly seasonal or part-time jobs – the types of jobs that pay low wages and do not offer health benefits. VIM patients are our fishermen, chamber maids, bartenders and even real estate agents; they are our neighbors and friends.
It is tough to work when you are sick or to pay for meds when you are having a hard time putting food on the table. VIM has a patient who is “lucky” enough to work for Public Works but as a “permanent temp” so he has no health benefits. Another patient has a pituitary tumor; although surgery is unlikely, there is a medication that keeps the tumor under control. It costs about $200/month. If VIM did not pay for this medication he would not be able to afford it. We look after a single mother with uncontrolled diabetes who eats too many carbs because pasta is much cheaper than meat and vegetables. All of VIM patients say “without you, I do not know what I would do.”
The book of Deuteronomy, Chapter 15, and verse 11 says “The needy will never be lacking in the land; that is why I command you to open your hand to your needy kinsman.” This is the historic role of free clinics, and a role that will be required for the foreseeable future. So while the politicians and pundits continue to debate health care, the volunteers at VIM and free clinics like VIM all around this nation will continue to be necessary. Will continue to provide care for the uninsured; will continue to struggle to make ends meet; continue to advocate for access to care and medications; will continue to make a difference. Isn’t it time America said enough is enough?
Contact Meiluta at jmeiluta@vimcmc.org or visit www.vimcmc.org.